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When 10-year-old Paul Toala had to "open wide" for a nurse, his tonsils were found to be red, inflamed and "enormous".

Paul, of Rongomai School in East Tamaki, said his throat became sore the night before nurse Tracy McKee checked him for symptoms of streptococcal throat infection.

An untreated group A "strep" throat infection can lead to acute rheumatic fever, an auto-immune response that can damage the heart valves and lead to prematuredeath.

Rheumatic fever is linked to poverty, overcrowding and poor access to healthcare. Maori people are 10 times more likely, and Pacific people 21 times more likely, to be admitted to hospital with the disease than Europeans or other ethnicities, Otago University research has shown.

The Government is trying to stamp out the disease in a $24 million, five-year campaign that includes sore-throat clinics at schools in low-income areas of seven health districts.

A large South Auckland schools trial and later studies have shown these clinics can cut rheumatic fever rates by 60 per cent.

Associate Health Minister Tariana Turia, who has described New Zealand's rheumatic fever rate as a crisis, is scheduled to mark the formal launch of the South Auckland part of the scheme at Rongomai School today.

Paul is the second pupil at the school to have had a sore throat checked since the scheme started there this week. Teachers will send any pupils with a sore throat - whose parents have consented - to the nurse each morning.

Ms McKee, from the National Hauora Coalition, said she was not surprisedthat Paul's throat was sore.

"He's got tonsils that almost touch in the middle and they're very red."

She also found glands in his neck were enlarged, but he did not have a fever, or pus on his throat, which, with enlarged, inflamed tonsils could be signs of strep infection.

"Two out of four [signs] is more than enough to be suspicious of strep. I will be surprised if it's not."

She wiped a long cotton bud on Paul's throat - which Paul said tickled but didn't hurt - to send to a laboratory to check for streptococcal bacteria.

If the result, which can take up to 48 hours, comes back positive, Ms McKee will deliver a 10-day course of antibiotic medicine to his home for him to take.

Rongomai is one of six schools in Counties Manukau where the programme - with add-on health checks funded by the local health board - starts this term.

It will later be extended to 12 more, but Auckland University paediatrician Professor Diana Lennon said the area needed 60 school sore-throat clinics.

RHEUMATIC FEVER* Can result from untreated streptococcal throat infection.* Can damage heart valves.* Maori and Pacific children worst-affected groups.* About 125 new cases each year nationally.* About 50 South Auckland children affected each year.